Community Youth Scholarship Fund Funded by tax dollars from the City of Manhattan and Private Donations Scholarship Application Form Child=s Name: Birth Date: Parent Name: Grade: Home Phone: Address: Office Phone: City/State/Zip: Email: Are you a military dependent? G Yes G No Are you submitting a scholarship application for anyone else in your family? G Yes G No If Yes, name of child or children: Program you wish to participate in: Start Date: Total Registration Fee: $ Scholarships are awarded on the basis of financial need. Please explain why you are applying for a scholarship. Print clearly. Family/Household Size: Total Annual Family Income: $ Parent/Guardian Signature: Date: NOTE: UFM is the administrative agent for the scholarship. The information you provide on this application form is kept strictly confidential by UFM. Return application to: UFM, 1221 Thurston Street, Manhattan, KS 66502 Questions? Call 785-539-8763 Date Received: Reason: Parent Notified: Voucher Issued Date: Computer Entry: For Office Use Only Scholarship Awarded: G Yes G No Amount Awarded: $ Voucher Returned Date: Rev. 09-04-2012 Community Youth Scholarship Fund Guidelines for Distribution Money has been made available through tax dollars from the City of Manhattan for use as scholarships for youth activities in Manhattan. Scholarships may be requested for any Manhattan program. UFM Community Learning Center is the administrative and distribution agent. Applications will be received at UFM. In order to provide as much assistance as possible, the following guidelines have been established. 1. Scholarships are available to help pay the partial costs of attending any youth program activity in Manhattan. Scholarships are available anytime during the year as long as funds are available. 2. Youth in grades Preschool-12th grade and residing in Manhattan are eligible for scholarships. 3. Scholarships are available to pay up to 50% of program activity fee or a maximum of $100 per person or $300 per family. This amount cannot be guaranteed. Total requests will determine the amount of individual scholarship awards that are possible. 4. One application will be accepted per child per semester. Scholarships will be awarded for only one class, activity or program session per child. For example, one UFM class, one session of day camp, one session of swim lessons. 5. Families should check with their desired program agency to be sure there are no scholarships available from that agency before applying to the Community Youth Scholarship Fund. 6. Income guidelines up to 185% of the poverty guideline generally apply, but may be reduced depending on amount of funding and total amount of scholarship requests. 7. Maximum age limit: Age 18 or High School Senior 8. Spring scholarships are awarded on an as-requested basis. Due to the high volume of requests for summer scholarships, summer scholarship applications are held until a set deadline and awards are made all at once. Fall scholarships may be available if funds remain. 9. Awards will be made on timeliness of application and family need until funds are exhausted. Scholarship awards may be adjusted to provide assistance to as many children as possible. 10. Scholarship applications will be submitted to UFM Community Learning Center, 1221 Thurston, Manhattan, KS 66502. For questions, call 539-8763. 11. Awards will be made in the form of vouchers to present to the program in which the child is enrolling. The program will return the voucher to UFM for payment. No cash awards are made except by prior approval as reimbursement for enrollment. A receipt for the paid enrollment fee is required for reimbursement. 12. Awards will be made as soon as possible after applications are received or following set deadlines. Rev. 09-04-2012